Policy guru Julian Le Grand (pictured) is one of the prime movers behind the GP-style social work practices that trade unions see as a threat to the sector. But employees would be empowered by the system, he tells Kirsty McGregor
Imagine a future in which every family that moves into an area registers with a dentist, a GP and a social worker. In this brave new world, social work would not have the stigma it often has now.
This is one of many visions Julian Le Grand, professor of social policy at the London School of Economics (LSE), has for the profession.
A former policy adviser to Tony Blair, Le Grand has been credited with introducing choice and competition into healthcare and education.
He is also the man behind proposals to form independent, GP-style, social work practices.
These are mutual organisations owned and led by frontline staff, who share any profits and expenses. Le Grand mooted the idea in 2006 and the Labour administration included it in 2007’s Care Matters White Paper.
Five years on, several practices are being piloted in children’s services. The coalition government has expanded the pilots, and health secretary Andrew Lansley recently announced that the model would be piloted in adult services.
In February the Cabinet Office appointed Le Grand as chair of its Mutuals Taskforce. His role is to find ways to expand employee-owned mutuals across public services as part of the government’s Big Society agenda.
But where will this growing support for mutualism take the social work profession?
“Social work practices are not the answer to everything; it’s not one-size-fits-all,” Le Grand says, as he sips tea in his LSE base. “But I’d like to see them more widely adopted. If an employee feels they have control over what they do and how they do it, they provide a better service.”
He insists this is not a critique of all council-run services. But, controversially, he argues that social workers operating their own, independent practices could benefit from competition because it would encourage them to think creatively. “Competition gives incentives and opportunities for innovation,” he says.
This viewpoint has not made Le Grand popular with unions, he acknowledges. Unison has produced a 10-point guide to its objections to social work practices, one of which claims that “competition between practices for local authority business risks destabilising the system”.
There was also a concern that large corporations would swoop in and take over the smaller practices, in effect leading to the privatisation of social work.
Le Grand agrees that this is a risk, but he says the spirit of mutualism should guard against it. “It depends on the governance structure of the practice,” he says. “If they started operating as a private firm and issuing shares, that would be a problem.
“But if you have true employee ownership and you don’t issue shares, it’s difficult for big firms to take over.”
Unions also objected to the idea of bonus culture in social work.
Initially, Le Grand proposed a system whereby the contract between the local authority and the social work practice would be at least partly based on outcomes for service users. But Unison’s guide states: “There is no evidence that social workers are frustrated entrepreneurs who need a profit motive to do their best for children.”
Le Grand now accepts that social work is not ready for this approach.
“In practice, although the pilots looked at payment by outcomes, it hasn’t really materialised. Perhaps we don’t know enough about what works and what doesn’t. If worsening performance is not under the control of the person being paid, it looks like an arbitrary system.”
Not one to dwell on what hasn’t worked, Le Grand turns instead to contemplating future possibilities.
He muses that practices could form partnerships to take advantage of administrative economies of scale. But he dismisses the idea of super-sized practices formed of hundreds of practitioners or across local authority boundaries.
“My instinct is the smaller the better, because the sense of ownership is diluted the larger the organisation,” he says.
Clearly, Le Grand remains passionate about social work practices, whatever shape they may take. He often digresses into anecdotes about social workers pitching in to buy a plaque to commemorate a young boy’s dead mother or mopping up together after a flood in the office.
Trailing off from one of these stories, he pauses to contemplate the practice model and concludes: “It’s going in the direction one hoped it would.”
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This article is published in the 14 April 2011 edition of Community Care under the headline “Competition between social work practices spurs innovation”